Multimodality Treatment for Hepatoblastoma in Cooperation between Two Facilities

Abstract

Hepatoblastoma usually requires multimodality treatment including chemotherapy and operation such as extended hepatectomy and liver transplantation. In our medical area, the public pediatric hospital is available to perform chemotherapy for a pediatric patient with hepatoblastoma, while major hepatectomy is able to be performed in our hospital. A 3-year-old girl was referred to the public pediatric hospital with a chief complaint of fever and abdominal distention, and received a diagnosis of hepatoblastoma (PRETEXT II) by abdominal CT scan and liver biopsy. Six courses of chemotherapy were performed at the pediatric hospital and the tumor size reduced to one twentieth. She was transferred to our hospital to undergo an extended right lobectomy. Her postoperative course was uneventful and she returned to the pediatric hospital for chemotherapy. There was no recurrence thereafter. We have experienced a total of 4 cases of hepatoblastoma including the above between 2016 and 2019. Although 1 out of 4 cases (25％) had a postoperative complication, all were alive without recurrence for 4 years. Thus, when both chemotherapy and surgery for hepatoblastoma could not readily be performed in the same facility, it seems necessary to cooperate between two facilities to perform multimodality treatment.